Heart Failure Medications

Advances in medications have, over the past few years, made a big impact on the quality of life for heart failure patients. These medicines can help stabilize heart function, relieve symptoms, keep patients out of the hospital, even extend and improve quality of life.

But to be effective, patients must take an active role in understanding the medicines they are taking and foster open communication with their health care providers about how the medicines are affecting their health.

For example, some patients may be tempted to stop taking their medicine when they start to feel better. However, it is important to continue taking the medicine, as its purpose is not only to make the patient feel better in the short run, but also to treat the underlying disease and improve health in the long run.

Conversely, if a patient is taking medicine and feeling worse, or not feeling any better, it is important to discuss this with a doctor, as medicines may need to be changed or the dose adjusted to receive maximum benefits.

Most people with heart failure require several medicines for the best results. The list below describes the most common medicines available that may be prescribed for heart failure patients, courtesy of the Heart Failure Society of America. Patients should ask their doctor or their nurse for complete information on any medicines they are taking.

ACE Inhibitor Pills These medicines work by blocking the effects of harmful stress hormones. They also control high blood pressure and prevent heart attacks. In most people, they do not usually cause a lot of side effects but for some patients they can cause cough, or rarely, swelling of the lining of the mouth.

• Beta-Blocker Pills This group of medicines improve heart function. They also control high blood pressure, prevent heart attacks, and help regulate the heart rhythm. They work by blocking the effects of certain harmful stress hormones. Side effects include dizziness, fatigue, fluid buildup and wheezing.

• Diuretics Also called water pills, these work by helping the body get rid of extra fluid. Less fluid in the lungs makes breathing easier and means less swelling in other parts of the body. Patients taking a diuretic should have their potassium levels checked periodically. Diuretics can also cause people to lose too much fluid and become dehydrated.

• Digoxin Pills Improve heart function by making the heart beat stronger and also may help to correct hormonal imbalance that makes heart failure worse. Patients with heart failure breathe more easily and feel better as a result. Excessive amounts of digoxin may cause nausea or vomiting, blurred or colored vision or abnormal heart rhythm, which may cause palpitation or black outs. Digoxin should be used with care and close communication with a doctor’s office is required.

• Aldosterone Antagonist Pills These work by blocking the effects of a stress hormone called aldosterone. One study shows that people with advanced heart failure who take aldosterone blocking pills live longer and stay out of the hospital. It can increase potassium levels and can cause breast enlargement or tenderness, especially in men. Again, close communication with a doctor’s office is required if this medicine is used.

• ARB Pills These reduce the impact of certain harmful stress hormones. They have actions similar to those of ACE inhibitors and may be recommended for people who can not tolerate an ACE inhibitor. They can cause dizziness, decrease in blood pressure or problems with kidneys or potassium level.

• Combination Isosorbide Dinitrate and Hydralazine Pills This is a combination of two different vasodilators. These drugs work by relaxing blood vessels which eases the work of the heart. The combination may work particularly well in African Americans with heart failure but others are also likely to benefit. This combination can cause headaches, especially right after patients start taking the pills. Other side effects include dizziness, nausea, vomiting and feeling lightheaded or even fainting if patients drink alcohol or do not drink enough fluids.

Patients need to be sure to tell every doctor and nurse they see that they have heart failure and what medicines they are taking including over the counter medications, “nutriceuticals” or herbal remedies. Some of these can make heart failure worse or interfere with the prescribed medications from your health care provider. Heart failure patients should be particularly cautious about taking non-steroidal anti-inflammatory medicines (NSAIDs), calcium channel blockers and most antiarrhythmic medicines.